Saginala Kalyan, Barsouk Adam, Aluru John Sukumar, Rawla Prashanth, Padala Sandeep Anand, Barsouk Alexander
Plains Regional Medical Group Internal Medicine, Clovis, NM 88101, USA.
Hillman Cancer Center, University of Pittsburgh, PA 15232, USA.
Med Sci (Basel). 2020 Mar 13;8(1):15. doi: 10.3390/medsci8010015.
Based on the latest GLOBOCAN data, bladder cancer accounts for 3% of global cancer diagnoses and is especially prevalent in the developed world. In the United States, bladder cancer is the sixth most incident neoplasm. A total of 90% of bladder cancer diagnoses are made in those 55 years of age and older, and the disease is four times more common in men than women. While the average 5-year survival in the US is 77%, the 5-year survival for those with metastatic disease is a measly 5%. The strongest risk factor for bladder cancer is tobacco smoking, which accounts for 50-65% of all cases. Occupational or environmental toxins likewise greatly contribute to disease burden (accounting for an estimated 20% of all cases), though the precise proportion can be obscured by the fact bladder cancer develops decades after exposure, even if the exposure only lasted several years. Schistosomiasis infection is the common cause of bladder cancer in regions of Africa and the Middle East and is considered the second most onerous tropical pathogen after malaria. With 81% of cases attributable to known risk factors (and only 7% to heritable mutations), bladder cancer is a prime candidate for prevention strategies. Smoking cessation, workplace safety practices, weight loss, exercise and schistosomiasis prevention (via water disinfection and mass drug administration) have all been shown to significantly decrease the risk of bladder cancer, which poses a growing burden around the world.
根据最新的全球癌症负担数据（GLOBOCAN），膀胱癌占全球癌症诊断病例的3%，在发达国家尤为普遍。在美国，膀胱癌是第六大常见肿瘤。90%的膀胱癌诊断病例发生在55岁及以上人群中，男性患此病的几率是女性的四倍。虽然美国膀胱癌患者的平均5年生存率为77%，但转移性膀胱癌患者的5年生存率仅为5%。膀胱癌最主要的风险因素是吸烟，占所有病例的50%-65%。职业或环境毒素同样对疾病负担有很大影响（估计占所有病例的20%），不过由于膀胱癌在接触毒素数十年后才会发病，即使接触仅持续数年，这一精确比例可能会受到影响而难以确定。血吸虫感染是非洲和中东地区膀胱癌的常见病因，被认为是仅次于疟疾的第二大致命热带病原体。由于81%的病例可归因于已知风险因素（仅有7%归因于遗传突变），膀胱癌是预防策略的主要目标。戒烟、 workplace safety practices（此处可能有误，推测是工作场所安全措施）、减肥、锻炼以及预防血吸虫感染（通过水消毒和大规模药物给药）均已证明可显著降低膀胱癌风险，而膀胱癌在全球造成的负担正日益加重。
